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Performance Enhancing Ration Components Program:Supplemental Carbohydrate Test

STO VA6. A..'. .'.) WU 140

Murphy, T.C., R.W. Hoyt, T.E. Jones, C.L.V. Gabaree, CC 3430385VA3AO0E.W. Askew, T.A. Skibinski, and M.L. Barkate

7, ....Q. . . ,Ti "EA(S) AND ADDRESS(ES) B. PERFOAr OQ '• ;0'T 1REPORT N!!•I'ErP i

U.S. Army Research Institute of Environmental MedicineNatick, Massachusetts 01760-5007

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The Performance Enhancing Ration Components (PERC) project supports theArmy Science and Technology Objective "Nutritional Strategies to Enhance SoldierPerformance." The focus of the PERC project is to demonstrate, throughnutrition intervention, enhancement of physical and/or mental performance inextreme environmental conditions or during sustained high-intensity work.In this PERC study, we examined the effects of a liquid carbohydrate(CHO) supplement on exercise endurance of Special Operations Forces (SOF)soldiers.

The results of this study have encouraging implications in that theydemonstrate that the sustainability and survivability of our combat forces can beenhanced through nutrition intervention. By tailoring the nutrient compositionof the diet, environmental and battlefield stress may be attenuated anddecrements in performance may be prevented.

i nice, -.r .T• -" 15. NU•.F. O• PIG•S

Liquid Carbohydrate Supplement, Special Operations ForcesSoldiers, Substrate Utilization, Physical Performance,Nutrient Intake.. 7- ", - . C TY CLASS!FICAT-N 1 -- -- -C 19. SECURITY CLASSIFICATICI 29. LOFri -!Q ArT

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PERFORMANCE ENHANCING RATION COMPONENTSPROGRAM: SUPPLEMENTAL CARBOHYDRATE TEST

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Supplemrental Carbohydrate Test

Murphy, T.C., R.W. Hoyt, T.E. Jones, C W.Gabaree, E.W. Askew2. Authors: E. A Sbkibnck M-I,_ -RrkqtP

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I

Technical Report No.

PERFORMANCE ENHANCING RATION COMPONENTS PROGRAM:

SUPPLEMENTAL CARBOHYDRATE TEST

LTC T.C. Murphy, Ph.D., R.D.1

R.W. Hoyt, Ph.D.2

T.E. Jones, M .S ., R .D .' -.............. .C.A. Gabaree, Ph.D.1

COL E.W. Askew, Ph.D.1

T.A. Skibinski, M.S. 3

M.L. Barkate, M.S., R.D.4

1Military Nutrition Division, 2Altitude Physiology and Medicine Division,

U.S. Army Research Institute of Environmental Medicine, Natick, MA 01760-5007

3 Sustainability Directorate,Natick Research Development and Engineering Center, Natick, MA 01760-5000

"4 Metabolic Kitchen,

Pennington Biomedical Research Center, Louisiana State University,Baton Rouge, LA 70808

October 1994

TABLE OF CONTENTS

LIST OF FIGURES...........................................ivLIST OF TABLES............................................ vACKNOWLEDGEMENTS ...................................... viEXECUTIVE SUMMARY ....................................... 1INTRODUCTION ............................................. 2

Background .............................................. 2METHODS ................................................. 4

Subjects ................................................ 4Experimental Design....................................... 4Anthropomnetric Data....................................... 6Resting Energy Expenditure .................................. 6Maximum Aerobic Capacity.................................. 6Endurance Exercise Testing .................................. 8Diet................................................... 8Carbohydrate Solutions..................................... 9Physiological Variables ..................................... 9Statistical Analysis ........................................ 10

RESULTS ................................................. 10Performance Results ...................................... 10Respiratory Results, Carbohydrate Oxidation ..................... 12Plasma Glucose and Insulin ................................. 15Plasma Free Fatty Acids, Blood Glycerol, and Blood Lactate..........15

DISCUSSION .............................................. 20Summary.............................................. 23

CONCLUSIONS............................................ 24RECOMMENDATIONS....................................... 25REFERENCES ............................................. 26APPENDIXES

A: Three-Day Menu...................................... 30B: Individual Run-to-Exhaustion Times ......................... 34

iii

LIST OF FIGURES

1. Experim ental design ...................................... 52. Exercise day schedule ..................................... 73. Mean run-to-exhaustion times ............................... 114. Daily resting respiratory exchange ratio ........................ 135. Exercise respiratory exchange ratio ........................... 146. Plasma glucose and concentration during performance trials ......... 167. Plasma insulin concentrations during performance trials ............ 178. Plasma-free fatty acid concentration during performance trials ........ 189. Plasma glycerol concentration during performance trials ........... 19

iv

LIST OF TABLES

1. Perform ance data ........................................ 122. Carbohydrate oxidation at 20, 50, 75, 100, and 125 min of exercise ... 15

v

ACKNOWLEDGMENTS

The authors would like to thank the Special Operations Forces soldiers from the7th SFG(A), Fort Bragg, NC, and 10th SFG(A), Fort Devens, MA, who participated inthis project. Without their uncompromising efforts this study could not have beencompleted.

We would also like to thank the superlative staff at the 'Pennington BiomedicalResearch Center. They were instrumental in the conduct of this study.

Additionally, we are grateful to the following personnel: 2Susan Mutter, for help(and patience) with statistics; 3Michael O'Guinn, for assistance with graphics; and2Karen Speckman, for technical editing.

16400 Perkins Road, Baton Rouge, LA 70808-4124.2 Geo-Centers, Inc., 7 Wells Avenue, Newton Centre, MA 02159.

3 Military Nutrition Division, U.S. Army Research Institute of Environmental Medicine,Natick, MA 01760-5007.

vi

"EXECUTIVE SUMMARY

The Performance Enhancing Ration Components (PERC) project supports theScience and Technology Objective "Nutritional Strategies to Enhance SoldierPerformance." The focus of the PERC project is to demonstrate, through nutritionintervention, enhancement of physical and/or mental performance in extremeenvironmental conditions or during sustained high-intensity work. In this PERC study,we examined the effects of a liquid carbohydrate (CHO) supplement on exerciseendurance of Special Operations Forces (SOF) soldiers.

On each of three test days during an 11-day experimental period, 18 SOFsoldiers performed a high-intensity, two-hour treadmill run in the morning. After aseven-hour rest, the subjects then performed a treadmill run-to-exhaustion. During thetwo days separating test days, subjects performed lower intensity treadmill runningand stationary cycling for a total time of one hour in the morning and one hour in theafternoon. Dietary intake of CHO and protein (PRO) was controlled to simulate theaverage daily intake in a field setting (4 g.kg-1 body weight [BW] and 1.5 g.kg-1 BW,respectively, or approximately 300 g.day-1 CHO and 112 g.day-1 PRO); fat intake wasset at a level to maintain BW. The effect of this diet was a transition from a CHO-predominant to a fat-predominant metabolism, as is normally seen in a field setting. Aplacebo (CHO-0) and two CHO treatments were provided to each subject: a 2.2 g.kg1

BW bolus immediately after the morning exercise (CHO-1), a 1.0 g.kg-1 BW bolusimmediately after the morning exercise, and a 0.4 g.kg' BW bolus three times at 20-minute intervals during the afternoon exercise (CHO-2).

Time-to-exhaustion was 6% longer for the CHO-1 (p=0.045) and 17% greaterfor the CHO-2 (p=0.0001) trials compared with the CHO-0 trial (114.1 ± 2.2, 120.5 ±2.2, and 133.9 ± 2.2 min for CHO-0, CHO-.1, and CHO-2, respectively). Additionally,CHO-2 mean time-to-exhaustion was greater than CHO-1 (p=0.0002).

The results of this study demonstrate how one nutritional intervention, CHOsupplementation, can enhance physical performance in a carefully controlled setting.This suggests that this intervention may have application in field combat settings toincrease soldier sustainability.

1

PERFORMANCE ENHANCING RATION COMPONENTS PROGRAM:

SUPPLEMENTAL CARBOHYDRATE TEST

INTRODUCTION

The Performance Enhancing Ration Components (PERC) project supports theArmy's Science and Technology Objective (STO): "Define and develop nutritionalstrategies and biotechnologies to enhance soldier performance in all environments"(Army Science and Technology Master Plan, 1993). The focus of the PERC project isto demonstrate, through nutrition intervention, enhancement of physical and/or mentalperformance in extreme environmental conditions or during sustained high-intensitywork. Subject matter experts presented current perspectives in this field at aNovember 1992 workshop hosted by the National Academy of Sciences Committee onMilitary Nutrition Research entitled "An Evaluation of Potential Performance EnhancingFood Components for Operational Rations." Utilizing the information reviewed at thisworkshop, scientists at the U.S. Army Research Institute of Environmental Medicine(USARIEM) and Natick Research, Development, and Engineering Center, Natick,Mass., formed a Joint Working Group and selected the most promising componentsfor studies within a military context. Potential performance enhancing rationsupplements chosen for further study were carbohydrate, glucose-electrolytebeverage, caffeine, glutamine, and tyrosine. In addition, food discipline (the timing offood and nutrient consumption in relationship to total food intake and performance)was identified as a potential "tool" to enhance performance. Supplementalcarbohydrate was selected as the initial PERC item to test.

BACKGROUND

As exercise intensity increases, muscle glycogen becomes the primary fuelsource. It is well known that carbohydrate is the rate limiting fuel for prolonged, high-intensity exercise. As glycogen levels decrease, perception of fatigue increases andcapacity to perform exercise above 70% VO 2max declines (Ivy, 1991). Subsequentreplenishment of glycogen stores is dependent upon an adequate dietary carbohydrateintake. After exercise that significantly lowers glycogen levels, rapid synthesis ofglycogen occurs in response to carbohydrate feeding (Bergstrom & Hultman, 1967).However, timing of the carbohydrate feeding is important. Maximum glycogen

2

synthesis occurs when carbohydrate is supplied immediately post-exercise ascompared to two hours post-exercise (Ivy et al., 1988). The amount of carbohydrate

provided is also important. Consumption of 0.7-1.5 g.kg-1 body weight (BW)

immediately post-exercise allows for maximum glycogen storage (Blom et al., 1987

and Ivy & Lee, 1988). The rate of storage is decreased by about half when the

amount of carbohydrate provided immediately post-exercise is reduced to 0.35 g.kg1

BW (Blom et al., 1987).

Several studies have demonstrated that carbohydrate supplementation during

cycling enhances physical performance in subjects consuming a diet adequate in

calories and carbohydrate (Wright et al., 1991, Coyle et al., 1986, and Hargreaves et

al., 1984). One cycling study also demonstrated increased performance when

supplemental carbohydrate was provided to subjects on a carbohydrate restricted diet

(Neufer et al., 1987). Further, it has been shown in subjects consuming their usual

training diet that provision of carbohydrate before and during cycling exercise

enhances performance to a greater degree than when carbohydrate is eaten only

before exercise (Wright et al., 1991). Several studies of runners, however, have failedto show an improvement in performance with supplemental carbohydrate (Riley et al.,

1988, Noakes et al., 1988, and Sasaki et al., 1987). The work of Riley et al. (1988)

was of particular interest as they studied subjects who had fasted for 21 hours before

the performance trials, presumably resulting in lowered glycogen stores.

On average, soldiers in the field receiving military rations consume only about

300 g.day"1 of carbohydrate, with a total daily caloric intake of approximately 2500

calories (Jones et al., 1990). This amount of carbohydrate is significantly lower than

that recommended for glycogen repletion (Costill et al., 1981, and Robergs, 1991).

The Committee on Military Nutrition Research, National Academy of Sciences,

recognizing that an optimum intake is difficult to achieve in a field setting,

recommends a carbohydrate intake of at least 400 g.day" for soldiers (1988).

Most of the previous work demonstrating an ergogenic effect with supplemental

carbohydrate has been performed with subjects consuming a carbohydrate-adequate

diet. The objectives of this study were to determine the following: (1) if supplemental

carbohydrate would enhance the performance of soldiers consuming a diet with a

macronutrient composition similar to that eaten in a field setting; and (2) if timing of

3

carbohydrate consumption would alter the magnitude of any performance enhancing

effects of carbohydrate.

METHODS

SUBJECTS

Eighteen highly motivated male Special Operations Forces (SOF) soldiersvolunteered to participate in the study after giving informed written consent. Their

mean (±SD) age, height, weight, % body fat, and VO 2max were 30 ± 3 yr, 178 ± 8

cm, 83.2 ± 8.7 kg, 18.5 ± 5.8%, and 4.31 ± 0.44 L.min 1 , respectively. This study wasapproved by the Human Use Review Committees at USARIEM and the U.S. Army

Medical Research and Materiel Command.

EXPERIMENTAL DESIGN

During the experiment, the subjects lived on an inpatient metabolic ward. The

experimental timeline is shown in Figure 1. At the start (day 1) and at the end (day11) of the experiment, these measurements were taken: height, weight, body

composition, and maximum aerobic capacity (VO 2max). Exercise testing wasperformed three times, on test days 4, 7, and 10, with two rest days (R) preceding

each exercise test day (E). On each exercise day, in the morning the subjectsengaged in endurance exercise and in the afternoon, the subjects engaged in exercise

consisting of prolonged, submaximal treadmill exercise to exhaustion (Figure 2).

Using a counterbalanced, single-blind, repeated measures design, the subjects were

given a placebo, or one of two carbohydrate treatments after the morning exercise and

during the afternoon run-to-exhaustion. The placebo (CHO-0) was a non-nutritive

solution provided at both exercise sessions. CHO-1 provided 2.2 g.kg-1 BW ofcarbohydrate in a single bolus immediately after the morning exercise and placebo

during the afternoon exercise. CHO-2 provided 2.2 g.kg1 BW of carbohydrate in a

divided dose: 1.0 g.kg-1 BW immediately following the morning exercise and 0.4 g.kg1

BW at 20, 40, and 60 min time points during the afternoon exercise. Ambient

temperature and relative humidity were 17 ± 10 C and 82 ± 6%, respectively.

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ANTHROPOMETRIC DATA

Pre-test vertical height was measured in duplicate to the nearest 0.1 cm using astadiometer (Holtain Stadiometer, Holtain, Ltd.). Body weight was measured in themorning, after the subject voided but before breakfast, using an electronic scale(model 6800, Cardinal Detecto) accurate to 0.1 kg. Body composition was determinedby dual energy X-ray absorptiometry (DEXA)(Hologic, Waltham, MA) soft tissue andbone mass analyses, as previously described (Mazess et aL, 1990).

RESTING ENERGY EXPENDITURE

Resting energy expenditure (REE) was determined on all R-Days. V0 2 andVC0 2 were measured using a metabolic cart with a ventilated hood system(SensorMedics, 2900z, Anaheim, CA), which was calibrated against gases of knownconcentration before each test session. Measurement was made on supine subjectsover a 30-min period, and the values were averaged over the last 10-min . Subjects'REE and respiratory exchange ratio (RER) for this 10 min period were calculatedusing the equations derived by Weir (1949).

AEROBIC POWER (VO 2max)

A continuous, treadmill exercise protocol was employed to elicit VO 2max; theprotocol was a modified version of that described by Costill and Fox (1969). After a 3-minute warm-up at 1.56 m-sec-1 (3.5 miles per hour) and 0% grade, the speed wasincreased to 2.5 m-sec-1 (5.6 miles per hour) for 3 minutes (0% grade). The grade wasmaintained at 0% for the following 3-minute stage while the speed was increased to3.35 m.sec-1 (7.5 miles per hour). Thereafter, the speed was held constant while thegrade was increased by 2% every 2 minutes beginning with a 4% grade, until VO2maxwas achieved. Previously established criteria were used to determine attainment ofVO2max (Thoden et al., 1983). Respiratory gas exchange was continuously monitoredvia an open circuit spirometry system (Sensor Medics, 2900Z, Anaheim, Calif.), whichwas calibrated using gases of known concentration before each test.

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ENDURANCE EXERCISE TESTING

Exercise Days

Exercise days were comprised of a morning and an afternoon treadmill session.

During the morning session, subjects completed a two-hour treadmill run

(Q-55, Quinton Instrument Co., Seattle, Wash.) during which exercise intensity was

35% of VO 2max for five min, 50% for 55 min, and 75% for one hr. Following a 7-hrrest period, a treadmill run to exhaustion was performed. Exercise intensity for this

afternoon exercise session was 35% of VO 2max for five min, 50% for 55 min, 75% for

30 min, 80% for 30 min, and 85% until exhaustion.

Rest Days

During rest days, the subjects exercised one hour in the morning and one hour

in the afternoon. Each of these exercise sessions consisted of 30 min on a cycle

ergometer and 30 min on a treadmill, both performed at 50% of VO2max. Theseexercise sessions were supervised and intensity was continuously monitored by heart

rate response (Polar Pacer, Polar CIC, Port Washington, N.Y.).

DIET

Dietary intake of soldiers was controlled to simulate the average daily intake of

carbohydrate and protein in a field setting: 4g.kg1 BW carbohydrate and 1.5g.kg-1 BW

protein (or about 300 g.day-1 carbohydrate and 112 g.day-1 protein for a 75 kg soldier)

(Jones et al., 1990). Fat intake was set at a level to maintain body weight. The 3-day

cycle menu is listed in Appendix A. Subjects began the controlled diet regimen three

days before endurance testing began. Test diets were designed using the ExtendedTable of Nutrient Values (ETNV) (Moore & Goodloe, 1990). Food and beverage items

were weighed to the nearest 0.01 g (Mettler balance PM4000, Hightstown, N.J.).

Subjects were strongly encouraged to consume all foods and beverages provided;

unconsumed foods and beverages were weighed and subtracted from the total. Water

and caffeine- and calorie-free beverages were available ad libitum. Subjects were

asked to limit caffeine intake to one cup of coffee per day for 10 days prior to the

8

study. Caffeine-containing beverages and medications were not available during the

study.

CARBOHYDRATE SOLUTIONS

A placebo (CHO-0) and two carbohydrate treatments (CHO-1, CHO-2) were

provided to each subject: CHO-1 = 2.2 g.kg-1 BW immediately after the morning

exercise session and placebo during the afternoon exercise session; and CHO-2 = 1.0

g.kg-' BW immediately after the morning exercise and 0.4 g.kg-1 BW at 20, 40, and 60

min during the afternoon exercise session (Figure 2). In the CHO-1 session,

supplemental carbohydrate was administered as a 25% solution of maltodextrin

(Maltrin M500, Grain Processing Corporation, Muscatine, Iowa), aspartame, flavoring,

and coloring; the CHO-2 beverage was identical except that it was an 11%

maltodextrin solution. Formulated and tested to be indistinguishable, the placebo

(CHO-0) was sweetened, flavored, and colored to resemble CHO-1 and CHO-2.

Total fluid volumes of CHO-0, CHO-1, and CHO-2 consumed were dictated by body

weight, but were identical between trials for each subject (range: 1094 to 1280 ml).

Additional plain water was provided ad lib.

PHYSIOLOGICAL VARIABLES

During the afternoon endurance exercise trials, 02 consumption (V0 2) was

measured with an on-line metabolic analyzer (Sensor Medics 2900Z, Anaheim, Calif.).

Respiratory exchange ratio was determined from VO2 and VCO 2 measurements.

Substrate oxidation was calculated using the equation of Weir (1949). Respiratory

samples were collected for 5-min intervals at 20, 50, 75, 100 and 120 min of exercise.

Venous blood samples were collected at 0, 40, and 70 min of exercise and

immediately post-exercise (IP). Blood samples were acquired from an indwelling

venous catheter, which was previously inserted into a superficial forearm vein. The

catheter was kept patent with isotonic saline. All samples were collected in the upright

posture. The pre-exercise (0 min) sample was preceded by a 20-min postural

equilibration period. Blood for glucose, free fatty acid, glycerol, and insulin analyses

9

was transferred to plain test tubes. Serum was collected after centrifugation andfrozen at -80°C until subsequent analysis.

Glucose, glycerol,and free fatty acids were analyzed on the Beckman SynchronCX5 analyzer using Beckman (Brea, Calif.) CX reagents for glucose, Sigma (St Louis,

Mo.) reagent for glycerol, and WAKO (Dallas, Tex.) reagent for free fatty acids. The

latter two analyses were adapted to the Beckman CX5 at the Pennington BiomedicalResearch Center (Clinical Research Laboratory Manual, Pennington Biomedical

Research Center, Baton Rouge, La.).

Insulin was analyzed by microparticle. enzyme immunoassay on the Abbott lMxautomated immunochemistry analyzer using Abbott (Chicago, Ill.) reagent. Recovery

of spiked samples was 93-106.7%. Inter-assay variance was 3-8%.

STATISTICAL ANALYSIS

A regression line was calculated for run-to-exhaustion times utilizing leastsquares estimates. The mean response for each subject was calculated andcompared across the five different treatment sequences using ANOVA to test for anyinteraction between the treatment effect and the order given. A three-way ANOVA,with terms for subject, period, and treatment, was then run to test for treatment effect.

Other comparisons were made using one-way analysis of variance for repeatedmeasures. Level of significance was P<0.05. Post hoc comparisons were made

using the Student-Newman-Keuls test.

RESULTS

PERFORMANCE RESULTS

Mean time-to-exhaustion was significantly higher for CHO-1 (120.5 ± 2.2 min,p=0.045) and CHO-2 (133.9 ± 2.2 min, p=0.0001) compared to the control (CHO-0114.1 ± 2.2 min) (Figure 3). Individual times-to-exhaustion are listed in Appendix B.

Additionally, endurance time for CHO-2 was greater than CHO-1 (p=0.0002).

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Table 1 Performance Data

Trial n R p vs.CHO-0 p vs.CHO-1

(as calculated) (LS means)

CHO-0 16 116.9 114.1 0.045

CHO-1 17 118.0 120.5 0.045

CHO-2 16 135.9 133.9 0.0001 0.0002

RESPIRATORY RESULTS, CARBOHYDRATE OXIDATION

Daily resting RER data (Figure 4) indicated that the physically active soldiersadjusted to a field-type military diet by day 2 (RER 0.82) and remained in a state of

fat-predominant metabolism throughout the remainder of the experiment. RestingRER decreased during the study from about 0.86 to 0.77, denoting that the

contribution of fat to the resting fuel mix increased from approximately 48% to 76%(Lusk, 1928).

RER values during exercise are shown in Figure 5. The RER during CHO-1

trial was higher than CHO-0 at all time points measured during exercise (p<0.05);CHO-2 was greater than CHO-0 at all measurements except at the 20-min mark

(p<0.05).

As expected, carbohydrate oxidation increased as exercise intensity increased.In addition, carbohydrate oxidation differed among treatments. Carbohydrate oxidationwas greater (p<0.05) during CHO-1 than CHO-0 at 20, 50, and 100 min. CHO-2

carbohydrate oxidation was significantly greater (p<0.05) than CHO-0 at 50, 75, and100 min, and was greater (p<0.05) than CHO-1 at the 75 min measurement (Table 2).Total carbohydrate oxidation during the exercise test was greater (p<0.05) in CHO-1(241 ± 75g) and CHO-2 (279 ± 89g) compared to CHO-0 (186 ± 63g). V0 2 and RERwere used to estimate the rate of carbohydrate oxidation.

12

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Table 2 Carbohydrate oxidation at 20, 50, 75, 100, and 125 min of exercise,

expressed as g.min"1

CHO-0 CHO-1 CHO-2

20 min 1.45 ± .32 1.76 ± .42* 1.55 ± .42

50 min 1.19 ± .29 1.53 ± .50* 1.62 ± .35*

75 min 2.16 ± .41 2.52 ± .64 2.67 ± .33*

100 min 2.29 ± .61 2.92 * .73" 2.95 ± .81*

125 min 2.67 ± .70 2.98 ± .66 3.27 ± .85

Values are x ± SD. *Significantly different than CHO-0 (P<0.05).

PLASMA GLUCOSE AND INSUUN

During CHO-1, blood glucose was higher (p<0.05) immediately post-exercise(IP) compared to CHO-0 (Figure 6). Compared to CHO-0, blood glucose was greater

(p<0.05) at 40 min, 70 min, and IP during CHO-2. Plasma insulin was increased

during CHO-2 at 70 min compared to CHO-0 and CHO-1 (Figure 7).

PLASMA FREE FATTY ACIDS, BLOOD GLYCEROL, AND BLOOD LACTATE

During CHO-1, free fatty acids (Figure 8) were lower (p<0.05) than CHO-0 at 40

min and 70 min. Plasma-free fatty acids (Figure 8) during CHO-2 were lower (p<0.05)than CHO-0 at 40 min, 70 min, and IP. During CHO-2, glycerol (Figure 9) was lower(p<0.05) than CHO-0 at 40 min and 70 min, and lower (p<0.05) than CHO-1 at 70

min.

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DISCUSSION

There were several important findings in this study. The first was that a liquidcarbohydrate supplement increased treadmill run-to-exhaustion time in physicallyactive soldiers. A significant increase in endurance time (6%) was also observedwhen the entire allocation of carbohydrate (2.2 g.kg-') was consumed in the morningimmediately after a routine exercise bout. These results are consistent with reports ofthe effects of CHO supplementation on cycle exercise endurance. Wright et al. (1991)demonstrated a significant 18% increase in endurance of subjects who consumed5 g.kg' carbohydrate 3 hr before exercise. Similarly, Sherman et al. (1991) reported a12% improvement in endurance time when subjects were fed 1.1 g.kg1 carbohydrate 1hr prior to exercise.

A dramatic increase in treadmill endurance time (17%) was achieved whencarbohydrate was consumed (a) immediately after a morning treadmill run (1.0 g.kg-1)and (b) at 20 min intervals during the afternoon test of exercise endurance capacity(0.4 g.kg-1, at 15, 35, and 50 min of exercise). These data agree with those of Wrightet al. (1991) who found endurance time increased by 44% in subjects fedcarbohydrate both 3 hr before exercise (5 g.kg-1) and during exercise (0.2 g.kg1). Inaddition, Neufer et al. (1987) showed a significant 22% increase in work output after45 min of cycling at 77% VO 2max when subjects ingested 200 g carbohydrate 4 hrbefore exercise and 45 g carbohydrate 5 min before exercise.

Total carbohydrate oxidation during the endurance exercise test was 30%higher during CHO-1 and 50% higher during CHO-2 compared to CHO-0 (p<0.05).The mean amount of supplemental carbohydrate provided to each subject was 182 g.An additional 55 g and 93 g of carbohydrate was oxidized during CHO-1 and CHO-2,respectively. Thirty percent of the supplemental carbohydrate provided during CHO-1was utilized during the run-to-exhaustion compared with 51% of that supplied duringCHO-2.

As was found by other investigators (Coyle et al., 1986, and Hargreaves et al.,1984), carbohydrate ingestion during exercise was associated with higher bloodglucose levels and lower free fatty acid and glycerol levels. The decrease in glyceroland free fatty acids during the CHO-2 trial suggests an inhibition of lipolysis (Wolfe et

20

al., 1990, and Wolfe and Peters, 1987). A similar pattern was evident during CHO-1,although glycerol was not significantly different from CHO-0. The significant decreasein free fatty acids, combined with an insignificant decrease in glycerol, could be

attributed to increased free fatty acid utilization (Hurley et al., 1986, and Nurjhan et al.,

1988).

The exercise routine in the present study involved exercise at progressively

greater intensities (Figure 2). The larger contribution of carbohydrate to fuel oxidationat the higher intensities resulted in an elevation of the RER. As compared to CHO-0,the increase (p<0.05) in the RER for CHO-1 at all measurement times, and for CHO-2at all measurement times except the 20-min mark, likely reflects the increased

availability and metabolism of carbohydrate (Pirnay et al., 1977). These findings areconsistent with the results of other investigators (Wright et al., 1991, Coyle et al.,1986, and Neufer et al., 1987). The RER at the 20-min measurement was higher forCHO-1 than CHO-2 (p<0.05); thereafter, the RER for CHO-2 tended to be higher (NS).The higher intake of carbohydrate after the morning exercise during CHO-1 (2.2 g.kg-1vs. 1.0 g.kg-1 for CHO-2) may have resulted in increased glycogen repletion compared

to CHO-2. Although previous work has shown no significant difference in glycogenrepletion at these levels of carbohydrate intake in subjects consuming a high-

carbohydrate diet (Ivy et al., 1988, and Blom et al., 1987), there may have beendifferences in glycogen deposition in these CHO-restricted subjects. Pre-exerciseelevations in muscle glycogen facilitate increased glycogen utilization and

carbohydrate oxidation during exercise (Coyle et al., 1985), and this could haveresulted in the higher RER during CHO-1 at the 20-min measurement. The

carbohydrate supplement consumed during the CHO-2 run-to-exhaustion would havebeen available for rapid oxidation (Pirnay et al., 1977), and may have resulted in the

tendency for the higher CHO-2 RER during subsequent measurements (Flatt et al.,

1985).

The work by Flatt et al. (1985) provides a possible explanation for our results.The addition of fat to a meal does not result in a concomitant increase in the RER. In

contrast, carbohydrate oxidation is closely tied to carbohydrate availability. In Flatt'sstudy, oxidation of carbohydrate increased with the ingestion of carbohydrate and then

decreased as the available carbohydrate was oxidized or stored. Similarly, when oursubjects consumed all the carbohydrate after the morning exercise session (CHO-1),

21

an increase in carbohydrate oxidation, as well as utilization for glycogen repletionprobably occured. This would result in less carbohydrate being available as fuel at thesubsequent treadmill run. Providing a portion of the carbohydrate after the morning

run and the remainder during the afternoon run (CHO-2) was clearly a more effective

method of delivery. In CHO-2, the carbohydrate consumed during the run-to-

exhaustion was, in all probability, available for use as fuel. Indeed, Pirnay et al.(1977) demonstrated that a 100-g load of carbohydrate administered during exercise is

completely oxidized during a 4-hr exercise bout.

It is likely that the performance enhancement of the CHO-1 and CHO-2regimens is related to hepatic energy reserves. Due to the activity level and limited

carbohydrate intake of subjects in this study, muscle glycogen stores were presumablylowered (Kirwan et al., 1988); it is likely that liver stores were also reduced. Ingestion

of carbohydrate after the morning exercise would have resulted in partialreplenishment of muscle (Ivy et al., 1988) and, presumably, liver glycogen stores.Increased carbohydrate would have therefore been available during the run-to-exhaustion for CHO-1 and CHO-2 compared to CHO-0. The oxidation of thecarbohydrate ingested during the afternoon session in CHO-2 (Pirnay et al., 1977)

probably spared hepatic glycogen.

Previously, it had been shown that a carbohydrate intake of 300 g.day-1 wasassociated with a transition to a fat-predominant state of metabolism in soldiers during

four days of moderate exercise (Jones et al*, 1990). In this study, administration of514 g.day-1 of carbohydrate to soldiers engaged in heavy exercise did not prevent a

transition from a carbohydrate-predominant to a fat-predominant metabolism.

During field maneuvers, food intake of soldiers is often limited to the amount of

food they can carry. The size and weight of military rations is tightly regulated;

carbohydrate content of rations is, therefore, limited by size and weight restrictions.The average daily carbohydrate intake for soldiers in a field setting is 300 g.day1

(Jones et al., 1990). When two or more bouts of high-intensity physical activity areexpected during the day, consumption of a large amount of carbohydrate immediately

after an exercise session appears to enhance performance at a subsequent session.Ivy et al. (1988) demonstrated the importance of consuming carbohydrate as soon aspossible after exercise completion for maximum glycogen resynthesis. However,

22

when supplies are limited, it may be more effective to spread consumption of theavailable carbohydrate over the entire day. Ingestion of carbohydrate during exerciseperiod(s) may provide for the most efficient utilization of carbohydrate as an exercise

fuel for the soldier in a field setting.

In future studies, different exercise intensities and durations than those

examined in this study need to be assessed. Also, this study does not address theeffects of glycemic index characteristics of different carbohydrates. Future researchshould examine the relationship of carbohdrate intake to hepatic glycogen stores and

human performance. Non-invasive 13C magnetic resonance spectroscopy techniques

may provide information in this arena.

23

CONCLUSIONS

1. Consumption of a liquid carbohydrate supplement enhances exercise performance.Maximum performance is observed when the carbohydrate is divided and consumedpartially after the morning and the remainder during subsequent exercise. When thesame amount of carbohydrate is ingested immediately after a morning exercise bout,endurance during a subsequent exercise session is also significantly increased but thebeneficial effects are not as great.

2. Dietary carbohydrate intake of 465 g.day-1 is insufficient to prevent a transition from

a carbohydrate-predominant to a fat-predominant metabolism in soldiers performingheavy exercise.

3. The transition to a fat-predominant metabolism can have a negative impact on

physical performance of soldiers, especially high-intensity physical performance.

24

RECOMMENDATIONS

1. Develop and type-classify liquid and solid carbohydrate supplements suitable forconsumption during physical activity.

2. Develop nutrition education tools to instruct soldiers on methods to achievemaximum ergogenic potential of rations.

25

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Blom, P.C.S., Hostmark, A.T., Vaage, 0., Kardel, K.R., and Maehlum, S. Effect ofdifferent post-exercise sugar diets on the rate of muscle glycogen synthesis. Med SciSports Exerc, 19: 491-496, 1987.

Committee on Military Nutrition Research. Military. Nutrition Research Annual ReportOctober 1. 1986-September 30, 1987. National Academy Press, Washington, D.C.,1988.

Costill, D.L., and Fox, E.L. Energetics of marathon running. Med Sci Sports Exerc,1: 81-86, 1969.

Costill, D.L., Sherman, W.M., Fink, W.J., Maresh, C., Witten, M., and Miller, J.M. Therole of dietary carbohydrates in muscle glycogen resynthesis after strenuous running.Am J Clin Nutr, 35: 1831-1836, 1981.

Coyle, E.F., Coggan, A.R., Hemmert, M.K., and Ivy, J.L. Muscle glycogen utilizationduring prolonged strenuous exercise when fed carbohydrate. J AppI Physiol, 61: 165-172, 1986.

Coyle, E.F., Coggan, A.R., Hemmert, M.K., Lowe, R.C., and Walters, T.J. Substrateusage during prolonged exercise following a preexercise meal. J Appl Physiol, 59:429-433, 1985.

Flatt, J.P., Ravussin, E., Acheson, K.J., and Jequier, E. Effects of dietary fat onpostprandial substrate oxidation and on carbohydrate and fat balances. J Clin Invest,76: 1019-1024, 1985.

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"Hargreaves, M., Costill, D.L., Coggan, A., et al. Effect of carbohydrate feedings onmuscle glycogen utilization and exercise performance. Med Sci Sports Exerc, 16:

219-222, 1984.

Hurley, B.F., Nemeth, P.M., Martin, W.H., Hagberg, J.M., Dalsky, G.P, and Holloszy,

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Ivy, J.L., Katz, A.L., Cutler, C.L., Sherman, W.M., and Coyle, E.F. Muscle glycogen

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1480-1485, 1988.

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Jones, T.E., Hoyt, R.W., Baker, C.J., et al. Voluntary_ consumption of a liquid

carbohydrate supplement by special operations forces during a high altitude coldweather field training exercise. Natick, MA: U.S. Army Research Institute of

Environmental Medicine, Technical Report T20-90, 1990.

Kirwan, J.P., Costill, D.L., Mitchell, J.B., et al. Carbohydrate balance in competitive

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Lusk, G. The Elements of the Science of Nutrition. (4th ed.) Academic Press, New

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Neufer, P.D., Costill, D.L., Glynn, M.G., Kirwan, J.P., Mitchell, J.B., and Houmard, J.Improvements in exercise performance: effects of carbohydrate feedings and diet. JAppi Physiol, 62: 983-988, 1987.

Noakes, T.F., Lambert, E.V., Lambert, M.I., et al. Carbohydrate ingestion and muscleglycogen depletion during marathon and ultramarathon racing. Eur J AppI Physiol, 57:

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Nurjhan, N., Kenney, F., Consoli, A., Martin, C., Miles, J., and Gerich, J.Quantification of the glycolytic origin of plasma glycerol: implications for the use of therate of appearance of plasma glycerol as an index of lipolysis in vivo. Metabolism., 37:

386-389, 1988.

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Sherman, W.M., Peden, M.C., and Wright, D.A. Carbohydrate feedings 1 h beforeexercise improves cycling performance. Am J Clin Nutr, 54: 866-870, 1991.

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29

APPENDIX A: THREE-DAY MENU

MENU 1: RDAY

AMOUNT BREAKFAST WEIGHT (g)4 oz. Orange Juice 118.01 oz. Raisin Bran 28.42 pats Margarine 10.02 ea. Biscuits 122.82 ea. Sausage Patties 77.18 oz. Whole Milk 226.8

LUNCH1 ea. Ham and Cheese Sandwich:2 oz. White Bread 50.02 oz. Ham 56.71 oz. American Cheese 28.4

Lettuce Leaves 20.0Tomato Slices 28.4

1 pc Mayonnaise 9.01 oz. Doritos 28.42 ea. Chocolate Chip Cookies 34.412 oz. Diet Decaf. Soft Drink 369.6

DINNER4 oz. Beef Brisket 113.63 oz. Mashed Potatoes 85.22 pats Margarine 10.01 oz. Beef Gravy 28.43 oz. Broccoli Au Gratin 85.22 ea. Croissants 113.64 pats Margarine 20.01/2 cup French Vanilla Ice Cream 72.612 oz. Diet Decaf. Soft Drink 369.6

SNACK6 ea. Peanut Butter/Cheese Crackers 85.212 oz. Diet Decaf. Soft Drink 369.6

30

MENU 2: R DAY

AMOUNT BREAKFAST WEIGHT (g)

8 oz. Orange Juice 236.0

5 oz. Scrambled Eggs 142.02 ea. Sausage Patties 113.12 ea. Biscuits 122.82 pats Margarine 10.01 oz. Grape Jelly 28.44 oz. Whole Milk 113.4

LUNCH3 oz. Hamburger Patty 85.2

Lettuce Leaves 20.0

Tomato Slices 42.51 pc Mayonnaise 9.01 ea. Hamburger Bun 40.01 oz. Doritos 28.42 oz. Pound Cake 56.812 oz. Diet Decaf. Soft Drink 369.6

DINNER

3 oz. Chicken Breast 85.24 oz. Rice Pilaf 113.61/2 cup Green Beans 68.01 pat Margarine 5.02 ea. Dinner Rolls 61.22 pats Margarine 10.02 ea. Brownies 56.6

4 oz. Whole Milk 113.4

SNACK5 ea. Ritz Crackers

1 oz. Cheddar Cheese 28.412 oz. Diet Decaf. Soft Drink 369.6

31

MENU 3: E DAY

AMOUNT BREAKFAST WEIGHT (g)4 oz. Orange Juice 118.0

1 oz. Corn Flakes 28.42.5 oz Banana Slices 85.2

1 ea. Biscuit 61.42 pats Margarine 10.01 pc Grape Jelly 14.28 oz. Whole Milk 226.8

SNACK1 ea. Cheese Sandwich:2 oz. American Cheese 56.81 pc Mayonnaise 9.02 sl. White Bread 50.01 oz. Corn Chips 28.412 oz. Diet Decaf. Soft Drink 369.6

DINNER

Spaghetti with Meatballs6 oz. Spaghetti 170.42 pats Margarine 10.06 oz. Spaghetti Sauce 170.4

6 oz. Meatballs 170.41 oz. Parmesan Cheese 28.4

Tossed Salad2.5 oz. Iceberg Lettuce 71.01 oz. Diced Tomato 28.4

1 oz. Cheddar Cheese 28.43 oz. Avocado Slices 85.23 Tbsp Bacon Bits 1.1

4 Tbsp Ranch Salad Dressing 60.5

32

a

"MENU 3: E DAY (cont.)

AMOUNT DINNER WEIGHT (g)

Garlic Bread:1 sl. Italian Bread 28.42 pats Margarine 10.0.25 tsp. Garlic Powder 0.034 oz. Whole Milk 113.41 cup Vanilla Ice Cream 145.21/2 cup Strawberries 128.8

33

* APPENDIX B

INDIVIDUAL RUN-TO-EXHAUSTION TIMES (MINUTES)

SUBJECT CHO-0 CHO-1 CHO-2 ORDER

1 st iteration

10 106 108 115 CHO-2,0,1

02 120 120 135

03 104 105 12004 * 100 111 CHO-1,0,2

05 140 124 157 "

06 125 106 135 "

07 119 130 160 CHO-0,1,2

08 130 152 180 "

09 96 125 127 "

2nd iteration

11 136 123 154 CHO-1,0,2

12 95 90 *

13 95 99 *

14 123 124 149 CHO-1,2,0

15 91 100 104 "

16 123 129 153 "

17 * * 129 CHO-2,1,0

18 123 136 125 "

19 145 135 120

- injury; did not start/complete run

CHO-0: placeboCHO-1: 2.2 g CHO/kg BW 15 minutes post morning exercise sessionCHO-2: 1.0 g CHO/kg BW 15 minutes post morning exercise session,

and 0.4 g CHO/kg BW at 10, 30, and 50 minutes during theafternoon exercise session

34

*

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